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Background The current low state of food security amongst Inuit in Canada is influenced by policy choices. Policy actors develop and implement policies, yet few research studies include their perspectives. This study includes policy actors’ perspectives on gaps and areas of improvement for policies that pertain to food security for Labrador Inuit in Nunatsiavut. Nunatsiavut is one of the four Inuit land claim areas in northern Canada making up the Inuit homeland, or Inuit Nunangat. It is situated in northern Labrador in the province of Newfoundland and Labrador, Canada. Methods This qualitative study consisted of key informant interviews conducted from July 2020-December 2020 with policy actors that spanned the Nunatsiavut Government (regional Inuit government), Government of Newfoundland and Labrador (provincial government), the Government of Canada (federal government), non-governmental organizations and private industry. Participants were asked about their role, policy gaps and opportunities for improving policies that pertain to food security in Nunatsiavut. It also included initial insights from emergency food security measures implemented during the first wave of COVID-19 in 2020. Results Fifteen key informant interviews were completed, and three participants provided written responses. The results were reported as per the consolidated criteria for reporting qualitative studies (COREQ): 32–item checklist. Seven participants (39%) stated they developed policy, six participants (33%) stated they both developed and implemented policy and five participants (28%) stated they implemented policy. Seven themes were identified from discussions with policy actors. Policy recommendations to improve food security include improving transportation, social policies, and policy coherence in policy implementation. Five separate themes were identified from discussions on implementing emergency food security measures during the first wave of COVID-19 in Nunatsiavut. These included inadequacy of social policies, hidden poverty among people living in Nunatsiavut and future considerations for post- COVID-19 food security policies. Conclusion The results of this study show that improving food security in Nunatsiavut is a matter of health equity. During COVID-19, these inequities were further highlighted, demonstrating the importance of urgent action. Findings from this study can inform actions to improve existing and future policies that pertain to food security for Labrador Inuit in Nunatsiavut.

Aim To determine if diabetes awareness campaigns are an effective intervention to reduce diabetes ketoacidosis at diagnosis of type 1 diabetes in children and youth. Methods Search strategies included PubMed, Scopus, CINAHL and WOS electronic databases, hand search of select journals and a grey literature search “Google” search to include all relevant information. Studies included community-based interventions focused on children younger than 18 years old. The difference in the frequency of DKA was measured in two separate comparisons; before and after perform awareness campaigns in the same area, and between areas with and without intervention campaigns. Results Of 1136 records identified, 14 studies were eligible for the analysis. The first group of 12 studies measured DKA at diagnosis, before (n = 6548 individuals) and after (n = 4931 individuals) the awareness campaigns. The pooled difference was a reduction of 7.20% (95%CI: 0.99–13.41). The second group of four studies measured the difference in an area with no intervention (n = 338 individuals) and in an area with an awareness campaign (n = 187 individuals). The pooled difference in DKA was 35.71% (95%CI: 5.81–65.61). Conclusions This review demonstrated that DKA awareness campaigns are effective to reduce DKA among children and adolescents with type 1 diabetes and the core components that explain why these campaigns are effective. Back to top.

Background: Despite efforts to promote an early type 1 diabetes diagnosis, Diabetic Ketoacidosis (DKA) amongst children and adolescents worldwide remains high. This article evaluated the effectiveness of intervention campaigns aimed at reducing the frequency of DKA at type 1 diabetes diagnosis in children and adolescents. Methods: The search strategies included PubMed, Scopus, CINAHL and Web of Science electronic databases, a hand search of select journals and grey literature. Studies included community-based interventions that assessed variation in the frequency of DKA related to awareness campaign interventions focused on children and adolescents younger than 18 years old. The difference in DKA frequency was measured in two separate comparisons. DKA frequency at diabetes diagnosis before and after intervention campaigns, and the difference in DKA frequency between areas with and without and intervention. Findings: Of 1136 records identified, 14 studies were eligible for the analysis. The first group of 12 studies measured DKA at diagnosis, before (n=6548 individuals) and after (n=4931 individuals) the awareness campaigns. The pooled difference in DKA frequency before and after an awareness campaign was 7.20% (95%CI: 0.99-13.41) The second group of four studies measured the difference in an area with no intervention (n=338 individuals) and in an area with an awareness campaign (n=187 individuals). The pooled difference in DKA was 35.71% (95%CI: 5.81-65.61). Interpretation: This review demonstrated that DKA awareness campaigns are effective to reduce DKA among children and adolescents with type 1 diabetes. Moreover, this study demonstrated why these campaigns are effective as it summarized the core components contributing to outcomes. These components can guide future intervention campaigns and serve as the basis for future research. Funding Statement: None. Declaration of Interests: No potential conflicts of interest relevant to this article were reported.